Chronic Pain Support Group

Physicians and professionalsdefine pain as chronic if it lasts longer than three to six months and is persistent. It's distinct from acute pain that is a direct result of injury or trauma. This support group is dedicated to those suffering from chronic pain. Discuss treatments that have worked for you, find advice for your specific experience, and find support. You're not...

Opioid Abuse, Addiction Less Common

"The abuse and addiction potentials of opioid analgesics prescribed for patients with chronic pain have been of great concern. However, current research indicates that these problems are not as common or widespread as many seem to believe.

In an evidence-based review for Pain Treatment Topics (http://www.Pain-Topics.org), editor Stewart B. Leavitt, MA, PhD, summarizes the findings of major research investigations of these problems. "The research is extensive, but requires careful examination," he notes. "Unfortunately, news media, government agencies, and others have portrayed abuse and addiction associated with prescribed opioids as problems of much larger proportions than seems warranted by the evidence." Several comprehensive investigations support this assertion:

-- In an extensive review, combining results from 24 clinical studies, the overall rate of prescribed opioid analgesic abuse or addiction in patients with pain was about 3.3%. However, fewer than 2 out of 1,000 (0.19%) patients without a current or past substance-use disorder experienced problems with opioids prescribed for pain.

-- Similarly, a clinical investigation of patients receiving daily opioid therapy for chronic noncancer pain prescribed by primary-care physicians found that only 3.7% of patients had a confirmed opioid-use disorder. However, whether or not any of these patients also had prior substance-use problems was not examined.

-- A systematic review, encompassing 17 studies of patients with moderate-to-severe chronic noncancer pain who were treated with opioid analgesics for at least 6 months, found opioid abuse in only 0.4% of patients. Signs of opioid addiction were evident in only 1 case out of 2042 subjects evaluated (0.05%). Whether these extremely low rates were in the overall patient population or solely in those patients without prior substance-use problems is unknown.

Estimates of substance-use disorders among the general public range from 5% to as high as 67%, depending on the population examined; although, the exact percentages of those disorders involving solely opioids has been poorly defined. At the least, it seems fairly certain that the rate of opioid-use problems in patients prescribed those drugs for pain would be no greater than in the population at large, according to Leavitt's review. And, according to other experts, the data suggest that news media accusations of increased opioid abuse being associated with greater numbers of patients being prescribed opioids for chronic pain management are unfounded.

This topic is worthy of further investigation and debate; however, the preponderance of available evidence suggests that establishing medical policies or practices in pain management on a presumption of high rates of prescribed opioid-analgesic abuse or addiction could be misguided, resulting in added costs for healthcare delivery and the undertreatment of pain. Healthcare providers can be reasonably assured that only a very small percentage of their patients with chronic pain, if any, will exhibit abuse/addiction when receiving long-term opioid analgesics. And, this would be especially so in those patients who have not experienced substance-misuse problems in the past."

Thank you for this article summary. I really needed to see that as I have had chronic pain all my life and struggled with &quot;do I have an opioid addiction problem or don't I?&quot; I have never been able to answer this easily. Too long of a story...

I mercifully beat my pain after 12 years and 9 of those years were on opioid treatment. Most of those years, the dose was lower than what i needed to function, a short time, maybe a year total at 2 different times, i was treated adequately. Every dose was to address the pain. I never felt high, the pain seemed to 'soak it up'. When NeuroCranial Restructuring ended the need for meds after 12 years and 6 weeks of suffering nonstop, i never needed or sought another pill. The question was answered 100% for me, proven beyond a shadow of a doubt for this one person. I'm not so different from you - if you need meds to restore your quality of life .. it is a far different mechanism from addicition. My pain was lifted in 4 days of this miraculous treatment. I haven't had one iota of desire for another opioid dose since, not once. That's just one anecdotal story - but for me, i consider it simply cruel for pain-free people to deny meds to people who really need them based on their prejudices. SUre there may be some with addicition problems - it's cruel to deny them relief as well - even if they live in that grey area between. Help them manage it. my .02.

Glad this helped a few CPP's. What we are fighting is government propaganda and years of stigmatism. Completely unscientific and the studies do NOT support the Feds in all their 'medical expertise.' Don't feel guilty or 'less than,' because you have the LEGITIMATE DISEASE of chronic pain.

&quot;not much different than the debate about global warming. an expensive debate the politicians would rather have us continue to debate rather than do anything about.&quot;

I respectfully disagree with your first statement, it is critically different and here is why I believe this to be so.

Human beings are being denied the basic fundamental Human Right to pain care and we are dying each and every day, millions globally. And as American's Our Constitutional and Civil Rights are being violated as well, and the cost for the government's intrusion into medicine is resulting in immeasurable suffering and death. The under-treatment of chronic pain is this Nation's #1 Public Health Crisis.

I do agree with your second point, the government and so many of the pain advocacy groups are content with the status quo and the endless scholarly debates. Billions &amp; billions of dollars are at stake, supporting this nation's failed Drug War Policy is very profitable. We can remain it's silent victims or join this Civil Rights movement.

I will continue to say, the Pain Relief Network is the ONLY organization doing more than talking (or passing yet another ineffectual, &quot;Pain Bill,&quot;) about the barbaric state of pain care in this country.

We as CPP's can no longer be complicit in our own destruction by our silence. I encourage everyone to support this work in any way you can.

I have had a spinal fusion and before and after surgery have had chronic pain with my back because I also have spinal arthritis. My hands and feet go numb and I have lost feeling in those but I can still use my hands and walk even though I don't feel them. I take narcotic pain relievers for some time now and the doctors office has treated me like crap ever since ....I dont fit the stereotypical teenager that they usually do this fusion on, it was a 10 level fusion and I am almost 30 and had other medical issues other than that. I finally got fed up because I take my meds exactly as directed and they dont help entirely, but do take the edge off the pain...I talked to the office manager and described some of the instances where the nurses treated me like an addict because I needed a script called in ONE day early due to my pharmacy being closed on this past holiday. I dont use CVS or a huge chain anymore because it takes too long for them to fill a script and with this local pharm it takes five minutes and Im outta there. Anyway, the office manager called back and apologized to me for how that nurse acted and said that she had several complaints for that day and told me that they were going to refer me to pain management and that they are going to continue my meds. I finally felt like someone listened to me and I wasnt going just to get meds. Doctors are afraid of getting sued I think and this is the reason they think that so many people are addicted and try to wean them off narcotics so quickly. Just wanted to share my own experience with this problem...I do have a goal one day to be off the pain medicine altogether and have other ways to deal with the pain but right now I am only 12 weeks post op after someone put 21 screws and 2 rods in my spine and I still have arthritis in lower spine and now they want to do MRI on my neck because now I cant move my head very much! Sorry so long winded! Thanks for listening to the person that posted this useful info...Thanks for being on our side...those people out there that are actually using this stuff for a legitimate reason... Tania

Also, when I left the hospital trauma, my insurance denied the pain medication Oxycontin because they stated that &quot;it was for cancer patients only&quot; and that my pain was not severe enough to be able to pay for it. So the day I left the hospital and picked up my medication, my hubby had to fork over at least $150 for this one script and who knows what else for the others, but that was nuts. I was in a wheelchair and using a walker, but they felt that they couldnt pay for it because I was not in that kind of pain. How can HMOs decide for you what type of pain you are in? Ridiculous. Sorry, I am so passionate about this issue now being through it myself and I am soooo long winded. Sorry! Tania

thank you for the post. I have been on vicoden for 8 months and it always took more and more , maybe my pain was just getting worse and worse. i know it was both ...my new dr took me off of them and put me on a pain patch today, it works great and i dont have to worry about taking to many etc.

I have been on opiads for 6+ years now and would not have survived without them. Even now, with an intrathecal pump (morphine/ bupiviance) 24/7, Fentanyl Patches etc, the pain is ever present. I am only on this stuff to try and take the EDGE off the pain-I still have a great deal of pain with all these drugs. I NEED the opiads to survive, just like a diabetic needs insulin to survive. I remember seeing a neurologist about 3 yrs ago and he wanted me to go to a detox center. My therapist(at the time) behind my back, had sent him a letter saying she agreed. That the amount of opiads I was taking surely indicated I was addicted...WHAT!! I felt so betrayed. The 14 doctors I had seen over that 3 yr period confirmed my &quot;physical diagnosis and permanent nerve damage&quot; that was causing the pain.
Before this back injury, I was healthy, well and rarely even took tylenol. To claim I was an addict truly showed both their ingorance to my intractable pain. I still spend over 21 hours in bed per day. By the time I wake up, make &amp; have a cup of coffee &amp; a yogurt, the pain from standing, then sitting increases the pain and I'm back in bed again. Yes, I do try to ignore the pain (LOL) and have sat longer, did light grocery shopping and yes, there is shower day(exhausting), then I pay the price. Often after &quot;pushing&quot; it, I'm down flat literally for 2-3 DAYS hoping get down to a 6-7 pain level. Once that pain get stirred up,I'm white knuckling it,nauseated,sweats and taking xanax &amp; flexeril just to help calm me. My heart races for hours and I just cry and wonder is this it? Is this for the rest of my life? Where is the quality? But, I still am holding on to hope and remember my body needs the opiads like the diabete needs insulin.
We are not drug addicts looking for a &quot;high,&quot; we are true, honest patients seeking medical treatment from our physicians. We are not abusers and it is so good to see an article that brings this issue to light.
Thanks so much for sharing!!

I have been taking pain meds since I was 18 when I started having problems with endometriosis.
I have had a hysterectomy and ended that problem, thank God. I was able to have 2 children.
I have had chronic migraines since puberty at 16. First, I took tylenol and cried until they would end. Then in my 20's they got worse (stress and everything, I guess) and I had to take fiorcet and neutontin as a preventtive drug. The neurontin (besides being extremely expensive) made me dizzy and unable to balance myself. I quit taking it cause the results were not worth the suffering. In my 30's I started to self inject depro which didn't work well but I tried for over 2 months before stopping. I then took vicodin (40/mo) and I was running out before the month was over.
Then after the hysterectomy, they got even worse. Doctor says it's lack of hormones. I had a heart attack on the triptins and now can only get relief from 30mg morphine with 4 1/2 tabs of methadose taken as a preventative. I hate it but I don't after all this time, I don't think about the drug unless I have pain or I have gone a few days and it is out of my system. I start feeling queasy then. The doctor says I don't have an addiction but I see it as my body still needing the drug but he is more concerned about me craving it for no reason. Any sense to you? Did your doctor say anything along these lines?
I'm very worried and hate that I have to take them. If they came up with something non-narcotic and they weaned me off these narcs, I would never even think about taking one again.

A friend sent this to me..As far as I can see, grief will never truly end.It may become softer overtime, more gentleand some days will feel sharp.But grief will last as long as Love does - ForeverIt's simply the way the absence of your loved onemanifests in your heart. A deep longing accompaniedby the deepest Love some days. The heavy fog mayreturn and the next day, it may recede.Once again, it's...

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